Pseudolesions: Very common. Know-them to recognize them | |
Meningioma and hemangioma can simulate aggressive periosteal reaction | |
Meningioma: Calcification, dural tail, intense enhancement, hyperostosis. Beware of variable bone involvement. 1H-MRS: Alanine (specific) | |
Hemangioma: Expansile, trabeculated, spoke-wheel pattern, fatty content. | |
Epidermal inclusion cyst: Previous injury, DWI restriction | |
Dermoid cyst: DWI restriction, fatty content | |
Fibrous dysplasia: Young patient. “Ground-glass” matrix virtually pathognomonic. Possible predominant lytic-cystic component in calvarium | |
Eosinophilic granuloma: Young patient with focal lytic lesion with “button sequestrum” | |
Giant-cell tumor: Hypervascular bone expansion lesion with flow-voids | |
Aneurysmal bone-cyst: Bone-expanding lesion with fluid hemosiderin levels. May be secondary if prominent solid components | |
Myeloma/metastastasis: Elderly patients with multiple lesions | |
Blastic metastasis: Prostate, breast, transitional cell, neuroendocrine, PNET, lymphoma | |
Hypervascular metastasis: thyroid, renal, hepatocarcinoma, neuroendocrine and melanoma | |
Transdiploic or aggressive single lesion: Differential of plasmacytoma, metastasis, lymphoma or meningeal lesion (meningioma/ SFT). Functional imaging can be useful in narrowing differential |